By Progressive Dental Solutions
July 10, 2017
Category: Uncategorized
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Obstructive Sleep Apnea (OSA) is a growing epidemic in our US adult population. Current research indicates that it is a very underdiagnosed and undertreated malady. Less than 5% of those who actually have OSA have been diagnosed and successfully treated1. Obesity (BMI greater than 30)) has been shown to be the underlying cause in half of the cases. But there are numerous other risk factors for the condition that must not be overlooked. It is hardly just the overweight male with an 18 inch neck who snores loudly that can be afflicted with sleep apnea. I have treated many a patient who-on the contrary- is as “skinny as a bean” but for other anatomic characteristics that effect their breathing airway during sleep are just as susceptible.

Some of the “classic” risk factors for OSA are loud,disruptive snoring, large tongue,undersized upper and/or lower jaw, droopy and loose soft palate, neck size greater than 17 inch in men and 15 inch in women and nasal breathing limitations which often cause habitual mouthbreathing. The use of alcohol and sedative medications like xanax, valium and the like -especially in the evening hours-that relax and collapse the supporting muscles of the airway are considered lifestyle risk factors for sleep apnea. In addition, apneics may have one or more characteristic subjective symptoms such as unrefreshing sleep,excessive daytime sleepiness and lack of alertness, witnessed breathing stoppages and gasping episodes during sleep observed by their bed partner, and reduced dreaming (REM sleep). Physiological symptoms may include high blood pressure,acid reflux, nocturia (frequent nitetime bathroom visits), irregular heart rate including atrial fibrillation and pulmonary hypertension.

Like many other medical conditions, individuals can complete self-screening to help determine if they may be at risk for OSA and need to followup with an evaluation by a health professional. If clinical evaluation supports subjective screening then referral for diagnostic testing to confirm or rule out sleep apnea is in order.

The “gold standard” for assessing daytime sleepiness is the Epworth Sleepiness Scale (ESS). The scale scores one’s tendency to doze off in various passive and slightly active situations. A score of 10 or higher warrants clinical followup.

0 = no chance of dozing
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

 

SITUATION CHANCE OF DOZING
Sitting and reading
Watching TV
Sitting inactive in a public place (e.g a theater or a meeting)
As a passenger in a car for an hour without a break
Lying down to rest in the afternoon when circumstances permit
Sitting and talking to someone
Sitting quietly after a lunch without alcohol
In a car, while stopped for a few minutes in traffic
TOTAL:   

To check your sleepiness score, check total points shown above.

Other simple self screening tests like the STOP-BANG or the SLEEP Observer’s Scale can similarly support the need for followup by a health professional.

A research study showed that OSA was two times the risk factor than smoking and three times the risk factor than high blood pressure and obesity for heart attack2. Other recent information indicates that untreated severe sleep apnea results in five times the number of cancer deaths for those with all types of cancer3 . If you suspect that yourself or a loved one may have obstructive sleep apnea based on the information above a self-screening may be the first step you take in saving yours or their life.

 

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